Provider Demographics
NPI:1104324656
Name:ACTIVE 9 HOMECARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:ACTIVE 9 HOMECARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARO
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:951-350-0679
Mailing Address - Street 1:837 BUICK AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92582-4510
Mailing Address - Country:US
Mailing Address - Phone:951-350-0679
Mailing Address - Fax:
Practice Address - Street 1:837 BUICK AVE
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92582-4510
Practice Address - Country:US
Practice Address - Phone:951-350-0679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health